Clinical outcomes and protocol for the management of isolated congenital diaphragmatic hernia based on our prenatal risk stratification system.
J Pediatr Surg
; 55(8): 1528-1534, 2020 Aug.
Article
em En
| MEDLINE
| ID: mdl-31864663
ABSTRACT
BACKGROUND/PURPOSE:
The aim of this study was to evaluate our prenatal risk stratification system for risk-adjusted management in fetuses with isolated congenital diaphragmatic hernia (CDH).METHODS:
Ninety-four infants prenatally diagnosed with isolated CDH treated between 1998 and 2017 at our institution were included in this retrospective single-center cohort study.RESULTS:
The patients were prenatally classified into four risk groups Group A (nâ¯=â¯54), which consisted of infants with neither liver-up nor a contralateral lung-to-thorax transverse area (L/T) ratio <0.08. The infants in group A were divided into two subgroups Group A-1 (nâ¯=â¯24) consisted of mild conditions; and Group A-2 (nâ¯=â¯30) consisted of severe conditions; Group B (nâ¯=â¯23), which consisted of infants with either liver-up or L/T ratio <0.08; and Group C (nâ¯=â¯17), which consisted of infants with both liver-up and L/T ratio <0.08. The rates of survival to discharge in Groups A-1, A-2, B, and C were 100.0%, 100.0%, 87.0%, and 58.8%, respectively. The rates of intact discharge were 91.7%, 90.0%, 52.1%, and 23.5%, respectively.CONCLUSIONS:
Our prenatal risk stratification system demonstrated a significant difference in the severity of postnatal status and clinical outcomes between the groups. STUDY TYPE Case Series, Retrospective Review. LEVELS OF EVIDENCE LEVEL IV.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Hérnias Diafragmáticas Congênitas
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article